BILL ANALYSIS Ó
AB 916
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ASSEMBLY THIRD READING
AB 916 (V. Manuel Pérez)
As Amended May 27, 2011
Majority vote
HEALTH 13-5 APPROPRIATIONS 12-5
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|Ayes:|Monning, Ammiano, Atkins, |Ayes:|Fuentes, Blumenfield, |
| |Bonilla, Eng, Gordon, | |Bradford, Charles |
| |Hayashi, | |Calderon, Campos, Davis, |
| |Roger Hernández, Bonnie | |Gatto, Hall, Hill, Lara, |
| |Lowenthal, Mitchell, Pan, | |Mitchell, Solorio |
| |V. Manuel Pérez, Williams | | |
| | | | |
|-----+--------------------------+-----+--------------------------|
|Nays:|Logue, Garrick, Mansoor, |Nays:|Harkey, Donnelly, |
| |Silva, Smyth | |Nielsen, Norby, Wagner |
| | | | |
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SUMMARY : Requires the Department of Public Health (DPH) to
assess the grants available pursuant to the federal Patient
Protection and Affordable Care Act (PPACA) for funding
opportunities related to the use of promotores. Specifically,
this bill :
1)Requires DPH to assess the grants to promote positive health
behaviors and outcomes available pursuant to PPACA for funding
opportunities related to the use of promotores in medically
underserved communities.
2)Requires DPH to report on this assessment to the fiscal and
health policy committees of the Legislature by April 1, 2012,
with recommendations for attaining and maximizing federal
funding.
3)Requires DPH to rely upon past research about the efficacy of
promotores and does not permit DPH to conduct new research.
4)Defines "promotores" to mean promoters de salud, also known as
community health workers (CHWs), peer leaders, or health
advocates, who serve as a bridge between the community and the
public health care system by providing health education,
health promotion, prevention, informational counseling and
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referral information, as well as resources, in a manner that
is culturally and linguistically appropriate.
5)Repeals the provisions of this bill on April 1, 2015.
FISCAL EFFECT : According to the Assembly Appropriations
Committee, minor, absorbable costs to DPH to prepare a report.
COMMENTS : According to the author, while it has been documented
that integrating promotores and CHWs in health programs and
strategies has been associated with improvements in access to
health care, health status, and health screening behavior, DPH
does not have a good grasp of the diverse promotores programs
operating in California, their level of success or their funding
sources. The author maintains that as increased federal funding
becomes available to California, it is incumbent upon the state
to have a comprehensive statewide strategy to target resources
and invest funding to proven programs, successful models, and
best practices.
According to the Health Resources and Services Administration
(HRSA), CHWs, also known as community health outreach workers,
community health advocates, peer health promoters, and, in
Spanish, promotores/as de salud, are generally community members
who work in community settings to connect health care consumers
to providers and to promote better health among groups that have
traditionally lacked access to adequate health care. CHWs live
in the communities in which they work, understand what is
meaningful to those communities, communicate in the language of
the people, and recognize and incorporate cultural buffers, such
as cultural identity, spiritual coping, and traditional health
practices, to help community members cope with stress and to
promote better health.
The federal Centers for Disease Control and Prevention (CDC)
states many health programs are turning to CHWs and promotores
for their unique ability to serve as "bridges" between community
members and health care services. CHWs can build partnerships
with formal health care delivery systems and provide a
community-based system of care and social support that
complements the more specialized services of health care
providers. CHWs also inform providers about the community's
health needs and the cultural relevancy of interventions by
helping providers and health care systems build their cultural
competence. A growing body of literature supports the role of
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CHWs in strengthening existing community networks for care,
providing community members with social support and education,
and facilitating access to care. CDC also notes that the
Institute of Medicine recommends the use of CHWs as part of a
comprehensive, multi-level strategy to address racial and ethnic
disparities in health care.
The term "health disparities" refers to a gap in quality of
health and health care across racial, ethnic, and socioeconomic
groups. HRSA defines health disparities as "population-specific
differences in the presence of disease, health outcomes, or
access to health care."
In the United States (U.S.), health disparities are well
documented in the African American, Native American, Asian
American, and Latino populations. When compared to whites,
these communities of color have a higher incidence of chronic
diseases, higher mortality, and poorer health outcomes. Among
the disease-specific examples of racial and ethnic disparities
in California, cardiovascular disease ranks as the leading cause
of death among Latinos, accounting for 23% of all deaths. In
addition, adult African Americans and Latinos have approximately
twice the risk as whites of developing diabetes. Communities of
color also have higher rates of cancer, HIV/AIDS, and infant
mortality than whites.
On March 23, 2010, President Obama signed PPACA; Public Law (P.
L.) 111-148, as amended by the Health Care and Education
Reconciliation Act of 2010; P. L. 111-152. The new federal
health reform law includes many provisions aimed at disease
prevention and promoting healthy lifestyles. The law creates a
$15 billion fund for programs designed to promote prevention and
wellness, such as efforts to address obesity and to help
patients manage chronic diseases. The U.S. Department of Health
and Human Services announced recently the availability of over
$100 million in funding for up to 75 Community Transformation
Grants aimed at helping communities implement projects proven to
reduce chronic disease, violence and injury, and improve mental
health and equity. PPACA also establishes a National
Prevention, Health Promotion, and Public Health Council to
coordinate federal efforts to promote healthy living.
Analysis Prepared by : Tanya Robinson-Taylor / HEALTH / (916)
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319-2097
FN: 0001003